I can remember the first safeguarding I raised well over a year ago. I was an A&E nursing associate.

The parents brought in a crying baby. They said the baby would not settle. I undressed the baby and discovered a large bruised handprint across the lower back.

A simple safeguarding recommendation. Unfortunately, these circumstances are more complex. A period of uncertainty and self-doubt frequently precedes the decision to express a concern.

Am I judging something that I don’t have enough evidence for? Do I think this is the right thing to do?

Do you think I should seek advice from a senior person first? The answers to these questions are always context-dependent. Still, if something makes you nervous, talking to the safeguarding lead or duty social worker about your concerns is always a good idea.

Previous concerns about the patient or family members may have existed, and your information is the final piece of the puzzle. It may also be nothing to worry about, but I handled it by expressing concern.

We have come a long way since Victoria Climbie in the early ’00s. The progress is evident in cases such as Baby P, Operation Bullfinch, and recent convictions of offenders such as those in the recent Rotherham case. While we are not yet at the point of a fully joined-up service where safeguarding is at the forefront of our minds, your efforts are contributing to this journey.

Then there are the cases of elder abuse. These cases tend to be more insidious as they don’t garner the same attention as those involving children.

The term’ poor historian’ refers to a patient who is unable to provide accurate or complete information about their medical history or current situation. This can complicate the safeguarding process, as it may be difficult to gather all the necessary information.

When information chains occur, it means that information is passed from one person to another, often in a sequential manner. However, as the information is relayed, assumptions are made, and it can become a game of “Chinese whispers,” in which a critical piece of information is lost or distorted due to each person’s interpretation of events. This may have a significant impact on the safeguarding process.

Then there is the deliberate misdirection of professionals by family members who can persuade staff that they have authority over a patient’s matters. Yet, no evidence has been produced to support that claim.

In my case, social services investigated and supported the family and individuals involved. Remember, you are not alone in these situations. There is a network of support ready to assist you.

Safeguarding doesn’t always mean taking children away or pointing fingers at blame. In some cases, there may be misguided family involvement, where family members may not fully understand the situation or the best course of action. This can complicate the safeguarding process, but it’s important to approach these situations with empathy and understanding.

It’s there for patient protection and to support vulnerable families and individuals.

It doesn’t stop you from doubting yourself, though.

wound care Tier 2 Certificate

Posted on June 6, 2024 by Bertha Adjei Ampomah

56692_Certificate_06Jun2024000650 56691_Certificate_06Jun2024000717 57200_Certificate_06Jun2024000725 59443_Certificate_06Jun2024000732

Wound care certificate.

Posted on June 5, 2024 by Bertha Adjei Ampomah

52985_Certificate_05Jun2024235349 52984_Certificate_05Jun2024235400 52986_Certificate_05Jun2024235300 53423_Certificate_05Jun2024235420 53851_Certificate_05Jun2024235428 59337_Certificate_05Jun2024235432 59337_Certificate_05Jun2024235457 61048_Certificate_05Jun2024235504My first week of simulated placement was a deep dive into wound care. I dove into the intricacies of managing patients with leg ulcers and the various types of wound dressing. A wound, as we know, is a disruption in the continuity of the epithelium. Understanding the normal physiological wound-healing process, which involves four stages—homeostasis, inflammation, proliferation, and remodelling—is crucial. This knowledge is particularly significant when dealing with chronic wounds, where the wound-healing mechanism is often impaired.

I learned the five ways of assessing wound care: wound assessment, wound cleansing, timely dressing change, selection of appropriate dressings, and antibiotic use. I knew pressure sores and leg ulcers were considered chronic wounds. They are slow-healing wounds with a likelihood of reoccurrence, and the pain that a patient feels may be severe and ongoing. The choice of dressing plays a significant role in reducing pain. Using the wrong dressing can cause discomfort when removing it. Therefore, the nurse needs to carefully assess before administering the dressing.

As a nurse, my role in promoting successful wound healing is pivotal. I must use a wound assessment tool to ensure accurate and consistent documentation, and regular reassessment of wounds is necessary to evaluate the effectiveness of the treatment. When conducting a wound assessment, I consider various factors such as the location, cause, tissue type, size, exudate, and the patient’s pain level. Selecting the most appropriate dressing for the wound is a critical decision, but it can be challenging due to the constant development of new dressings. I base my choice on the most current evidence available, and I must assess the wound for slough and necrosis, signs of infection, and malodor. Patient records should indicate the wound’s progress in healing, such as granulation and epithelial growth.

During my community placement, I had the opportunity to apply my theoretical knowledge in a practical setting. I visited a 60-year-old lady who had chronic leg ulcers on both legs. The district nursing team had been attending to her for several years. The lady had swollen legs and limited mobility and sat in a recliner chair, although the chair never reclined. I had visited her several times before, applied her dressings, and documented the procedures and dressings used in her district nursing records. On this occasion, the lady asked me not to apply the K-lite dressing and allowed another nurse to do it. She mentioned that the dressing I had used previously had become loose.

I assessed the wounds and updated the notes to reflect their current size. Then, I washed and redressed the legs according to the care plan. The plan specified washing the legs and applying Aquall Ag Silver, which is used for highly exudating wounds. Atruman was applied, followed by Resorb, Comfiest Yellow, and K-soft layers. I then handed it over to the registered nurse (RN) to use the final layer. While she did that, I documented that the patient’s leg had been washed, redressed, and mapped according to the plan. I also noted a strikethrough on the dressing before removal and recorded the patient’s pain levels before and after the redressing.61417_Certificate_05Jun2024235509